The UK Government has published its National Cancer Plan for England, backed by billions of pounds worth of investments in areas such as digital diagnostics, and informed by almost 12,000 responses to an earlier call for evidence from individuals and organisations.
Through the call for evidence, 70 percent of respondents identified earlier cancer diagnosis as a priority for the new plan, with actions for timely referrals from primary care, increased symptom awareness, and improved cancer screening. 61 percent selected “improving access to and quality of cancer treatment”, recommending increased treatment capacity, reviewing and updating treatment and management guidelines to improve pathways, and expanding genomic testing. Feedback was also collected around patient experience, aftercare, reducing inequalities, research, and data, with considerations outlined such as to speed up the adoption of new technologies.
Outlining the plan’s overarching goal of saving 320,000 more lives by 2035, Wes Streeting says: “To get there, we are drawing on the expertise and experience of patients, partners and professionals, harnessing the power of science and technology, and modernising the NHS to make sure medical discoveries reach patients faster….Today, people in the UK are less likely to survive cancer than people in comparable countries – and working class communities, like the one I grew up in, are being failed most of all. And so our ambition is unapologetically bold. We know that progress is possible because it’s already happening. Over 212,000 more people are getting a diagnosis on time, around 37,000 more are starting treatment on time, and rates of early diagnosis are hitting record highs. But we need to do more and go faster.”
Where it reports previous plans have failed to disrupt “outdated” care models, the government hopes this time to draw on the 10-Year Plan’s three shifts to redesign cancer pathways and modernise approaches to cancer care. Advances in data, genomics, and predictive analytics are in focus to drive pre-emptive care, it continues, while digital therapeutics and the NHS App will give patients choice and control, and partnership will promote innovation and access to clinical trials. A new system of “earned autonomy” and the creation of new incentives for innovation and modernisation are similarly hoped to support rapid transformation.
In line with the “five big bets” set out by the 10-Year Plan, the government draws up plans to increase the use of robotic surgery, publish a new specification for a national registry for robotically assisted surgery by March 2026, and develop new national training standards to support cancer surgeons in becoming “regular and expert users of surgical robots”. By 2035, half a million procedures will use robotic surgery, it suggests. AI tools such as Ambient Voice will help reduce staff time lost to admin tasks, and AI will assist oncologists in planning radiotherapy “more quickly and accurately”, with recommendations from a GIRFT study into maximising productivity in radiotherapy services to be implemented as soon as it is published.
From 2028, Single Patient Record data in the NHS App will help consolidate imaging, pathology, genomics, and care plans, supporting real-time MDT decision making, the government states. The NHS App will also become a dashboard for cancer prevention, offer direct access to tests and self-referral, and make digital therapeutics more accessible through the HealthStore. A national digital-first prehabilitation offer will be rolled out from 2028 to help patients get healthier before starting treatment, and a new cancer trials accelerator will “make the NHS the first-choice partner” for cancer clinical trials.
To deliver 9.5 million additional tests by 2029, the government relies on progress around diagnostics and the expansion of CDCs. £1.65 billion has been invested in CDCs since 2021, it shares, with 170 now up and running. A further £2.3 billion is to be invested over the next three years to build “many more” new CDCs and bring community diagnostics to more people, advancing the neighbourhood health service. Productivity will be further bolstered by the digitising of imaging services, and the deployment of MRI scanners with AI acceleration technology, which the government hopes will add capacity for 154,000 additional scans to March 2029.
Histopathology services will be transformed with a £604 million capital investment in digital diagnostics including digital pathology, as well as £96 million to automate histopathology and speed up processing and reporting. A transition will be made to digital and robotic automation-enabled histopathology pathways, with an estimated productivity gain of “up to” 21 percent. AI will play a role in speeding up lung cancer diagnosis, with the AI diagnostic fund expanded to all trusts over the course of the current Parliament.
Looking to ambitions to meet cancer waiting times standards by 2029, the government urges that “we must do more to break with ‘ business as usual'”. The use of single patient tracking lists will be scaled across local providers, using tech to identify earliest appointment times and offer real-time booking for diagnostic tests, with functionality developed within the Federated Data Platform to include booking and scheduling systems. Cancer will also be a priority for NHS Online, with a go-live date anticipated in 2027, promoting virtual cancer care.
Cancer Alliances will offer intensive support to “challenged trusts”, according to the government’s plans, with £200 million to be distributed to Cancer Alliances in 2026 to 2027 to be used for sustainable improvements to cancer delivery that “contribute to better performance and outcomes”. These Alliances will be strengthened by the sharing of more granular data, and efforts are to be made to rationalise and streamline cancer metrics to enhance their usability in driving improvement. “The Federated Data Platform (FDP) and tools like Cancer 360 will support trusts and Cancer Alliances to understand and mitigate bottlenecks and delays in pathways to improve performance,” the government highlights. “We will expect all providers to use the FDP or equivalent technology to improve operational performance from 2026/27.”
A more risk-stratified approach is being pursued through the use of digital tools like the FDP, and the government is looking to launch digital triage and booking pilots in cancer centres, as well as working to display all appointments in the NHS App. Incentives will be aligned with early diagnosis, with the introduction of Integrated Health Organisations (IHOs), combined with the move to multi-year budgets. IHOs will have “significant freedom to experiment more broadly within their contracts”, it adds, such as exploring new incentives like approaches to reducing emergency presentation.
“Despite significant investment in R&D, the NHS has struggled to adopt evidence-based innovations into routine clinical practice at scale and pace,” the government states. “Beyond the missed opportunities to save lives, achieve wider social benefit and reduce health inequalities it represents, it also makes the UK a less attractive place for global life sciences investment. Our new operating model will help us to change that. Multi-year budgeting, funding tied to outcomes not activity, and real incentives for innovation will help leaders take better risks.”
In line with this, the government expects the National HealthTech Access Programme for innovative technology laid out in the 10-Year Plan to accelerate approvals and adoption. A clear innovation pathway will also be developed with cancer as an exemplar condition, and support from the NHS Cancer Programme Innovation Call, NIHR, and the Office for Life Sciences’ Cancer Technology Adoption Fund.
A reformed National Cancer Board will be accountable for delivery of the National Cancer Plan, chaired jointly by DHSC and “an independent representative of the wider cancer community”. An annual summary of progress will be published, and a review will be undertaken at the three-year mark to consider the need for the plan to be updated.
To learn more about the National Cancer Plan, please click here.
Wider trend: Digital transformation in cancer services
Last summer, the DHSC announced a centralised system for cancer patients, built into the Federated Data Platform. The Cancer 360 tool collates data points across tests, appointments and treatments, displayed via a dashboard. DHSC highlights how this will help “track a patient’s progress and support personalised treatment plans”.
Royal Cornwall Hospitals NHS Trust (RCHT) is sponsoring a study exploring the relevance and effectiveness of the 1939 Cancer Act in an increasingly digital world, it has shared. Since the Act’s publication, the way health information is shared and accessed has changed “dramatically”, the trust states, with information widely available via the internet and social media. Led by Priya Joshi, consultant oncologist at RCHT, the study will seek to understand how patients find information on areas such as cancer diagnoses and treatment plans, “with a particular focus on the role of digital media in meeting information needs”.
The Clatterbridge Cancer Centre NHS Foundation Trust has shared updates on its digital and innovation work, outlining use cases of AI, ambient voice technology, and robotic process automation. On innovation the trust is utilising AI in developing models for predicting non-attendance and length of stay, with a dynamic dashboard also developed to report on survival, toxicity, and 30-day mortality. AVT is being piloted by the trust’s digital team, and Clatterbridge has committed to getting involved in a regional pilot. Its innovation team has also reported to have generated more than £160,000 in income through a range of projects and consultancy work over the last year.
